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Specialist nurses better value for money than doctors


Nurse specialists provide diabetes care of a similar quality to doctors and are more cost-effective, according to a study, which concludes nurses have not been used to their “full potential”.

The findings appear to contradict decisions by trusts to cut or re-assign specialist nurses in an effort to save money.

The two-year trial, by Maastricht University Medical Centre, compared hospital care given by nurse specialists with that given by doctors. Around 300 patients with type 1 or type 2 diabetes took part. 

Patient quality of life scores remained similar for patients receiving care from either type of clinician and the overall cost of care delivered was also similar.

A total of 1,003 outpatient consultations with the nurse specialist took place over the two years, with a total of 224.5 minutes of consultation time on average per patient during the study. This compared to 769 outpatient consultations with a doctor and a total of 85.8 minutes of consultation time on average per patient.

In addition, fewer of those treated by a nurse specialist developed diabetes related complications – 7% versus 12%.

The authors said: “The results of this study suggest that nurse specialists give care comparable to care provided by physicians in terms of quality of care and disease control.”

They said their findings showed nurse specialists were “more than capable” of taking the central role in multidisciplinary teams providing care to diabetes patients.

“Nurse specialists as central carers give a higher quantity of care, while utilising no more financial resources,” they add. “Instigating a nurse specialist as a central carer provides opportunities to achieve cost reductions.”

Simon O’Neill, Diabetes UK director of care, information and advocacy, said the study added to the evidence that specialist nurses were “able to provide excellent and cost effective care”.

“We believe that DSNs should be an integral part of the multidisciplinary team,” he said. “We feel the current trend of reducing their numbers is shortsighted and will impact on the long term health of patients.

“Nurses are already responsible for about 80% of direct diabetes care and we need to ensure that these nursing posts – hundreds of which are currently being frozen – are protected for the benefit of people with diabetes,” he added.


Journal of Advanced Nursing (2012) 68: 1224-34


Readers' comments (11)

  • I whole heartedly support the findings of this study with my own personal experiences of my local diabetes nurses. At the age of 19 my son was diagnosed with type 1 and without them my son and my family would have not been able to cope with this life changing diagnosis. They have been there for us every step of the way.
    I am a medical nurse with over 30 years experience.

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  • michael stone

    I am not surprised by this - because intelligent people improve with experience.

    My instinct, for example, is that a nurse who had spent 5 years treating people with malaria in Africa, would probbaly know much more about malaria than a typical doctor in England knows.

    I came across a comment about a diplomat, who I think ca 1930 to 1950 said 'go to the local doctors - they know more about the local diseases'.

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    obviously. that is why professionals move around to gain experience and why i moved from a long and highly successful and well paid career in a university hospital which I enjoyed to gain experience in smaller provincial clinics where you see cases never seen in the larger more specialist centres.

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  • This article has got it right.Specialist Nurses in all fields offer a great service.

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  • Anonymous

    Anonymous | 6-Jul-2012 10:14 am

    Why are telling Agent the point of the article is obvious, as you agree with him that it is - how come you are not saying the article is so obvious, there should have been no need for it to be written or pointed out ?

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  • So a specialist nurse gives the same care as a doctor but cheaper - what does that tell us?
    Either doctors are overpaid or nurses are underpaid!
    Maybe if the Dr spent as much time as the nurse with the patient they'd have even better outcomes, but it would cost twice as much!

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  • As Julie commented, this could either confirm that doctors are better-paid than nurses (and I think we all knew that) or else, had it been not the case, it would have proved that nurses are fairly useless !

    So I tend to agree with 'Dim's point. Anonymous | 6-Jul-2012 10:14 am is aiming a comment at 'Agent', when a more appropriate comment would be at the study itself, along the lines of 'why on earth does anybody need to prove this ?'. It isn't Agent who is being insulting to nurses, here, it is the assumption that this study was necessary to prove something ! But anonymous is, for reasons I cannot fathom, attacking Agent.

    I'm a bit surprised that 'mike' has not yet jumped in with 'this proves nurses should be paid the same as doctors'.

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  • Remember, this is a study from Germany where doctors are less well paid than their counterparts in the UK. Not sure about how much German nusres are paid though.

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  • of course nurse specialists are more cost effective than doctors.

    1 - they are cheaper to employ

    2 - they specialise in one particular area

    3 - they are more willing to work unsocial hours

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  • As I am the specialist Hematologas , I saw this situation about the value differences a few years ago. I am not suprised about this anymore

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